Citation

Van Den Bosch LMC. Tijdschr. Psychiatr. 2005; 47(3): 127-137.

Copyright

(Copyright © 2005, Uitgeverij de Tijdstroom)

DOI

unavailable

PMID

unavailable

Abstract

BACKGROUND: Dialectical behaviour therapy (DBT) is considered to be a promising treatment for patients with borderline personality disorder (BPD). However, the question is whether DBT can be regarded as the treatment-of-choice in the Netherlands for a mixed population of borderline patients with or without co-morbid substance abuse.

AIM: To investigate whether in the case of female BPD patients DBT is more effective than treatment-as-usual (TAU) in reducing borderline symptomatology and substance abuse.

METHOD: Fifty-eight women with BPD, referred from addiction centres (n=19) and psychiatric services (n=39) were randomly assigned to either 12 months of DBT or 12 months of TAU. Outcome measures included drop-out (treatment compliance), parasuicidal behaviour, self-damaging impulsive behaviour and substance abuse.

RESULTS: Compared to TAU, DBT resulted in lower drop-out rates (23% vs. 63%), less self-mutilating and self-damaging impulsive behaviour, and less alcohol abuse. At follow-up, 6 months after treatment had been discontinued, the benefits of DBT were still significantly more effective, but the size of the effect had become smaller.

CONCLUSIONS: DBT is superior to TAU in reducing high-risk behaviour and alcohol abuse in patients with BPD. If the effect of DBT is to be maintained, the treatment needs to be continued.

Language: nl

Keywords

human; female; suicide attempt; Borderline personality disorder; Netherlands; treatment outcome; comorbidity; Substance abuse; substance abuse; alcohol abuse; article; major clinical study; automutilation; behavior therapy; impulsiveness; follow up; borderline state; high risk patient; risk reduction; Dialectical behaviour therapy